Transcript The Economic Burden of Injury in Ontario

The Economic Burden of
Injury in Ontario
Dr. Philip Groff
Director, Research & Evaluation
SMARTRISK
SMARTRISK Learning Series
October 17, 2006
The Human Cost of Injury
Partners
• SMARTRISK
• The Hygeia Group
• Health Canada
• Emergency Health Services Branch -Ministry of Health and Long-Term Care
• Kingston, Frontenac and Lennox &
Addington Health Unit
Economic Burden Studies
Canada
1995
Ontario
1999
Saskatchewan
2001
Alberta
2002
Atlantic Canada
2003
Manitoba
2004
British Columbia
2001
Burden of Injury
Across Canada
Y.T.
n/a
n/a
N.W.T.
Nvt.
n/a
n/a
n/a
n/a
N.L.
$213
million
B.C.
$2.1
billion
920
582
PYLL
Alta.
$1.8
Sask.
billion
$595
PYLL
925
PYLL
million
1054
PYLL
Man.
$819
million
961
PYLL
Que.
Ont.
$2.9
n/a
P.E.I .
billion
$74
674
520
million
PYLL
837
PYLL
N.B.
N.S.
$502 $372
million
million
963
646
PYLL
PYLL
PYLL
A New Ontario Study
•
•
•
•
•
Update the numbers
and methodology
Include costs for
intentional injury
Breakdowns by Region
and LHIN
Focus on Alcohol
Focus on Physical
Activity
Thanks
• The Hygeia Group
• Ministry of Health & Long Term Care
• Ministry of Health Promotion
• Canadian Institute for Health
Information
• CAMH / APOLNET
• SMARTRISK Staff
The Electronic Resource
Allocation Tool (ERAT)
• Spreadsheet workbook in MS Excel
format
• Allows Incidence Costing
• In 1999 Dollars
• Based upon Provincial Data / Ratios
Incidence Costing
• Costs of injury over the life-course charged
to the year of the injury incident
– Contrast with Prevalence Costing
• Chosen because of the focus on injury
prevention
• Ability to evaluate cost savings from a
variety of potential prevention initiatives
specific scenarios in this study
Direct and Indirect Costs
• Direct Costs
• All costs to the health care system.
• Indirect Costs
• Lost productivity due to death and
disability.
Causes of
Injury Death
Ontario 1999
Violence
3%
Other
21%
Motor
Vehicle
22%
Falls
29%
Suicide
25%
Total
Deaths
4,044
Causes of Injury
Hospitalization
Ontario 1999
Other
24%
Falls
50%
Violence
3%
Motor
Vehicle
11%
Suicide
12%
Total
Hospitalized
75,176
Causes of
Non-Hospitalized Injury
Ontario 1999
Other
29%
Violence
2%
Suicide
15%
Falls
38%
Motor
Vehicle
16%
Total NonHospitalize
d
492,438
Summary of All Injury
Ontario, 1999
Injury
Deaths
Injuries
Injuries
Resulting Resulting
Nonin Partial
in Total
Hospitalize hospitalize Permanent Permanent
d Injuries d Injuries Disability Disability
Total
Annual
Cost
492,43
$5.7
4,044 75,176
20,693 1,426
8
Billion
Direct and Indirect Costs
Ontario, 1999
2,000
525
$ Millions
1,500
809
1,421
694
1,000
544
748
500
342
M
len
ce
Vi
o
e
cid
Su
i
le
Ve
hi
c
ot
or
Fa
l
Indirect Costs
Direct Costs
ls
0
er
139
91
Ot
h
421
Costs of Unintentional Falls
Ontario, 1999
1,000
1,000
489
384
500
257
250
0
0
l er
e
er
v
e
h
h
t
t
L no
O
e
m
A
Sa l To
ve
e
eL
157
154
76
66
274
+
548
105
55
250
243
750
014
15
-2
4
25
-5
4
$ Millions
137
$ Millions
927
750
500
35
Age Group
On
Type of Fall
Indirect Costs
Direct Costs
Costs of Motor Vehicle Traffic
Collision
Ontario,
1999
750
$ Millions
500
365
250
Injured Party
r
14
th
e
cl
ist
Cy
al
Pe
d
ot
or
cy
M
es
tri
a
Pe
d
123
12
17
D
riv
e
r/P
as
se
n
ge
r
n
0
42
24
O
81
58
cl
ist
Indirect Costs
Direct Costs
265
Costs of Intentional Injuries
Ontario, 1999
Interpersonal Violence
Suicide and Self-Inflicted
500
184
375
250
274
177
125
35
0
g
P
n
Ha
g
gi n
,
$ Millions
$ Millions
500
ni n
o
s
oi
g
an
r
t
S
ul
n
atio
uf f
,S
11
n
tio
a
c
o
ttin
Cu
g/
42
g
c in
r
e
Pi
148
her
Ot
ht
g
i
F
Indirect Costs
Direct Costs
250
125
0
15
Cause of Injury
375
42
46
28
13
ul t
i ng
a
ing
r
s
c
r
s
e
t
e
i
at
al a
b
/P
u
d
x
g
se
hil
t in
,
t
l
C
u
C
aw
, br
60
9
25
7
Cause of Injury
er
h
t
O
Injuries Resulting from
Physical Activity
Ontario, 1999
Injury
Deaths
192
Injuries
Injuries
Resulting in Resulting in
NonPartial
Total
Hospitalize hospitalize Permanent Permanent
d Injuries d Injuries Disability Disability
6,999 53,434 2,134
157
Total
Annual
Cost
$655
Million
Costs of Injuries Resulting from
Physical Activity
Ontario, 1999
200
$ Millions
150
100
56
83
83
87
64
50
Indirect Costs
Direct Costs
87
29
al
ki
ve
ng
re
xe
rti
Pe
on
da
lC
yc
Pl
ay
lin
gr
g
ou
nd
W
Fa
at
ll
er
Sp
or
t
O
W
n
lli
sio
co
rt
54
29
0
Sp
o
59
Type of Physical Activity
19
5
Estimated Cases of Injury
with
Alcohol Involvement
Ontario, 1999
% Nonhospitalized
Injuries
Type of Injury
% Deaths
% Hospitalized
Injuries
Motor Vehicle
Traffic Collisions
23
13
10
Unintentional
Falls
7
6
6
Suicide and
Self-Inflicted
Injury
14
12
12
Interpersonal
Violence
25
22
22
Costs of Injuries
Associated with Alcohol
Ontario, 1999
200
$ Millions
150
100
32
85
50
113
74
43
32
41
20
Type of Injury
ce
io
le
n
V
Su
ic
id
e
Fa
lls
VC
0
M
Indirect Costs
Direct Costs
Injury Prevention Cuts Costs
$1 spent on…
Saves
painting traffic lines on roads
$61
front seat belts
$49
functional family therapy for
juvenile delinquents
$32
smoke detectors
$15
comprehensive fall prevention
programs for community-dwelling,
high risk seniors
Big Brother/Sister mentoring for
violence prevention
intensive sobriety checkpoints
$7
$5
$3
Five Prevention Scenarios
• 20% reduction in falls among 55+
• 20% reduction in falls among children <15
• 30% reduction in MVC
• 20% reduction in self-inflicted poisoning
• 20% reduction in interpersonal violence
Total combined savings of $500 Million
annually
One Prevention Scenario:
Falls Among Seniors 55+
• In 1999 $927 million attributed to direct
costs of falls among those 55+
• The proportion of Ontarians ages 65+ will
nearly double by 2031, rising to 24%
• Existing strategies have been
demonstrated to reduce falls among
seniors by 20%
• 4,000 fewer hospital stays
• 1,000 fewer seniors disabled
• $121 million reduction in direct health
Conclusion
• Ontarians bear a heavy burden
• This burden is not static, there is a cost to
inaction
• Proven approaches to prevention exist
• Ontario needs to tackle the burden of
injury in a strategic way
www.smartrisk.ca